Angioplasty for Peripheral Artery Disease (PAD)

If you have pain in your calves or thighs when you walk, you might have narrowing or blockages in the blood vessels (arteries) that feed your legs. This is called peripheral artery disease or PAD. PAD is caused by a build-up of plaque, which prevents your muscles from getting enough blood to function adequately. Not only can PAD be painful, but it means you are at a higher risk for heart attack and stroke. In severe cases, PAD can cause such low blood flow that your toes and feet can start to develop wounds or dying tissue known as gangrene.

Luckily, there are good medications that can reduce this risk, and a variety of procedures, such as angioplasty, to help restore blood flow to relieve your pain and get you back to enjoying life.

How is PAD Treated?

For many people, PAD can be managed with medicines and lifestyle changes, like eating a heart-healthy diet and getting regular exercise. However, if your symptoms don't improve and are keeping you from your daily activities, your doctor may recommend that you consider a procedure. This could be either bypass surgery or the less invasive angioplasty procedure to restore blood flow.

What is Angioplasty?

During angioplasty, a vascular surgeon inserts a catheter (similar to a large IV) into your blood vessel and can identify areas of disease by injecting a special dye and watching the blood flow in real time. They can then guide the catheter to the area that is narrowed or blocked, and use a balloon to try to open the blood vessel. The balloon presses the plaque against the artery wall, improving the blood flow. The surgeon may also place a permanent stent (a small mesh tube) during the angioplasty procedure to help keep the artery open.

The procedure can last 30-90 minutes depending on how much work needs to be done. You will be given medications to help you relax during this time, but you will be awake enough to follow some simple instructions such as positioning your leg in one way or another.

When is Angioplasty Used?

Both bypass surgery and angioplasty immediately restore blood flow to the leg. Which procedure is best for you depends on how severe your blockages are. Some patients need both. Angioplasty usually works best in arteries with shorter segments of disease, and arteries that are just narrowed, not completely blocked.

Angioplasty is usually an outpatient procedure which means you can come to the hospital, have your procedure done, complete the recovery process, and go home the same day. Bypass surgery is more invasive and normally requires a few days stay in the hospital afterwards for recovery.

Recovering from Angioplasty

It is normal to be a little sore after your angioplasty procedure and you may even have some swelling, bruising, or a small lump around the site where the catheter went into your body. Your doctor will likely say you can do light activity around the house, but shouldn't lift anything heavy or do any hard exercise for several days.

The staff will review your post procedure care plan noting follow-up appointments, medications, and tips on how to have the best long-term results from angioplasty. These tips include:

• Quit smoking or never start. This is one of the most important things you can do for your heart and vascular health. There are many resources available to help you quit.
• Eat a heart-healthy diet, including lots offruits, vegetables, and whole grains. Limit salt and added sugar in your foods.
• Get regular exercise and stay at a healthy weight. Your doctor may recommend a special exercise program that can help you walk farther.
• Take care of your overall health, paying special attention to conditions like diabetes, high blood pressure, and high cholesterol.
• Be sure to take all medications that are prescribed to you. Your vascular surgeon may prescribed aspirin or other blood thinners to keep your blood vessels open after your procedure.

While learning you have PAD can be scary, it's comforting to know that lifestyle changes and procedures like angioplasty are available to help you return to your active life with minimal disruption.

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